Hypertensive emergencies in diabetic patients from predominantly African American urban communities

Benenson, Irina; Waldron, Frederick A; Dillon, Shelly A Jones; Zinzuwadia, Shreni; Mbadugha, Nkehci; Vicente, Natali; Aris, Ela; Adeboye, Adedamola M; Makdisi, Christine

doi:10.1080/10641963.2018.1516774

Cited by 3 publications

(10 citation statements)

References 27 publications

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“…The convergence of cervical afferent and trigeminal nerve pathways supports the discovery that therapies for cervical neck pain generators can contribute to PTHA relief. 4 Similar to other primary headaches, posttraumatic headache is clinically diagnosed. Laboratory and routine imaging diagnostics are unnecessary and have limited clinical utility.…”

Section: Discussionmentioning

confidence: 99%

“…The ICHD-3 temporal criteria lack specific phenotypic diagnoses that would enable clinicians to treat and manage the various forms of PTHA. 4 Post-traumatic headaches are secondary headaches that develop after a traumatic brain injury. Mild to moderate symptoms like a tension-type headache may accompany a post-traumatic headache.…”

Section: Discussionmentioning

confidence: 99%

“…Less than one-third of CPTHA patients experience "mixed headaches, " which are symptoms of the various forms of headaches that overlap. 4,5 It is coded as a secondary headache related to the trauma or injury (post-traumatic headache) when a new headache develops for the first time in close temporal proximity to trauma or injury to the head and/or neck. This still applies whether the newly developed headache resembles any of the primary headache diseases listed in Section 1 of ICHD-3.…”

Section: Discussionmentioning

confidence: 99%

“…reactive oxygen species, inflammation), and simultaneously form a vicious cycle and interconnected complications. 4 Endothelial dysfunction, a hallmark of hypertension and diabetes mellitus, is the primary initiator for atherosclerosis and thrombosis, eventually leading to acute events such as myocardial infarction and stroke. 4 Salagre, et al, found 39.7% of hypertensive emergency patients also have diabetes mellitus.…”

Section: Discussionmentioning

confidence: 99%

“…3 Hypertension and diabetes mellitus are common coexisting conditions and increase the short-term as well as long-term risk of various cardiovascular complications including stroke, CAD (coronary arterial diseases), heart failure, atrial fibrillation, and peripheral vascular disease. 4 CASE A 75-year-old man with a history of uncontrolled hypertension and type II diabetes mellitus was admitted to the emergency department with typical chest pain 1 hour before admission along with nausea and vomiting. The patient was conscious with a blood pressure of 200/100 mmHg, pulse rate of 92 bpm, and respiration rate of 22/minute with 98% oxygen saturation in room air.…”

Section: Introductionmentioning

confidence: 99%

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Non-ST Elevation Acute Coronary Syndrome (NSTEACS) as Hypertension-Mediated Organ Damage (HMOD) in Hypertensive Emergencies

Puspaseruni¹,

Rizka²,

Sakulat³

2023

Cermin Dunia Kedokteran

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Hypertensive emergencies are characterized by severe increases in blood pressure with evidence of hypertension-mediated organ damage (HMOD) and are associated with an increased risk of cardiovascular events, i.e. coronary heart disease (CHD) and mortality. Case: A 75-year-old man with typical chest pain with nausea and vomiting 1 hour before admission. Blood pressure was 200/100 mmHg, ECG showed T inversion in leads II, III, AVF, V1-V6 and prolonged QT interval, cardiomegaly on chest x-ray, and leukocytosis, hyperglycemia, and hypokalemia. The diagnoses were non-ST elevation acute coronary syndrome (NSTE-ACS), hypertensive emergency, and T2DM. Treatment in the ICCU consists of intravenous antihypertensive, antiplatelet, anticoagulant, statin, nitrate, insulin, and potassium chloride for electrolyte correction. The patient was admitted to the ICCU for further observation and management. Hipertensi emergensi ditandai dengan kenaikan tekanan darah yang sangat disertai bukti kerusakan organ yang progresif (hypertension-mediated organ damage - HMOD). Keadaan ini berkaitan dengan peningkatan risiko kejadian penyakit kardiovaskular, seperti penyakit jantung koroner bahkan kematian. Kasus: Seorang laki-laki usia 75 tahun dengan nyeri dada tipikal sejak 1 jam sebelum datang ke rumah sakit disertai mual dan muntah. Tekanan darah 200/100 mmHg, pada EKG didapatkan inversi T pada lead II, III, AVF, V1-V6, dan pemanjangan interval QT. Pada pemeriksaan X-ray dada didapatkan kardiomegali, hasil laboratorium menunjukkan leukositosis, hiperglikemi, dan hipokalemi. Pasien didiagnosis non-ST elevation acute coronary syndrome (NSTE-ACS), hipertensi emergensi, dan diabetes melitus tipe 2. Tata laksana di ICCU menggunakan anti-hipertensi intravena, anti-platelet, anti-koagulan, statin, nitrat, insulin, dan kalium klorida untuk koreksi elektrolit. Pasien dirawat di ICCU untuk observasi dan tata laksana lebih lanjut.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Non-ST Elevation Acute Coronary Syndrome (NSTEACS) as Hypertension-Mediated Organ Damage (HMOD) in Hypertensive Emergencies

Puspaseruni¹,

Rizka²,

Sakulat³

2023

Cermin Dunia Kedokteran

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Prevalence of Myocardial Injury and Myocardial Infarction in Patients with a Hypertensive Emergency: A Systematic Review

et al. 2022

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Myocardial injury and myocardial infarction can complicate a hypertensive emergency, and both are associated with poor prognosis. However, little is known about the prevalence of myocardial injury and the different subtypes of myocardial infarction in patients with hypertensive emergencies. This systematic review aims to determine the prevalence of myocardial infarction and its subtypes, and the prevalence of myocardial injury in patients with hypertensive emergencies following the PRISMA guideline. A systematic search of PubMed, Web of Science, and EBSCOHost (MEDLINE) databases was carried out from inception to identify relevant articles. A total of 18 studies involving 7545 patients with a hypertensive emergency were included. Fifteen (83.3%) studies reported on the prevalence of myocardial infarction ranging from 3.6% to 59.6%, but only two studies specifically indicated the prevalence of ST-elevation and non-ST-elevation myocardial infarction. The prevalence of myocardial injury was obtained in three studies (16.7%) and ranged from 15% to 63%. Despite being common, very few studies reported myocardial injury and the subtypes of myocardial infarction among patients presenting with a hypertensive emergency, highlighting the need for more research in this area which will provide pertinent data to guide patient management and identify those at increased risk of major adverse cardiovascular events.

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Non-ST Elevation Myocardial Infarction in Patients With Hypertensive Emergency

Prakash,

Dhewle,

Bose

et al. 2024

Cureus

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Background Hypertensive emergencies represent high-cardiovascular-risk situations defined by severe increases in blood pressure. The prevalence of hypertension in non-ST elevation myocardial infarction (NSTEMI) is higher compared to STEMI and there is a lack of studies on NSTEMI patients with hypertensive emergencies. Patients with diabetes exhibited a higher rate of hypertensive emergencies. This study's primary aim was to investigate the coronary artery disease profile in hypertensive emergency patients with NSTEMI, and the secondary aim was to determine the impact of diabetes on the development of hypertensive emergencies. Methodology A total of 100 patients with NSTEMI and hypertensive emergency presenting to the hospital were enrolled in the study. The duration of the study was 24 months. The patients were also sub-grouped into diabetic and nondiabetic. Baseline characteristics were noted, and coronary angiogram and renal angiogram were also done. Based on variables, the chi-square test and t-test were employed to assess the significance. P -value < 0.05 was considered statistically significant. Results The mean age at presentation for patients with NSTEMI and hypertensive emergency was 58 years. Patients consuming alcohol were slightly higher (28, 28%) than those who smoked (23, 23%). Among all, 48 (48%) patients had diabetes. When considering the number of vessels, diabetic patients had more single-vessel diseases (18, 37.5%) and nondiabetic patients had more double-vessel diseases (15, 28.8%). The mean ejection fraction of the diabetic group was 56.1% ± 6.8% and the nondiabetic group was 54.2% ± 7.7%. Among all the patients, 52 (62.6%) used combination drugs, while 39 (46.9%) were on defaulter drugs. Conclusions Several risk factors like age, smoking, alcohol, and nonadherence to drugs were found to have an association with the occurrence of hypertensive emergency. Diabetes was found to be significantly associated with unfavorable coronary anatomy among the population.

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Hypertensive emergencies in diabetic patients from predominantly African American urban communities

Cited by 3 publications

References 27 publications

Non-ST Elevation Acute Coronary Syndrome (NSTEACS) as Hypertension-Mediated Organ Damage (HMOD) in Hypertensive Emergencies

Non-ST Elevation Acute Coronary Syndrome (NSTEACS) as Hypertension-Mediated Organ Damage (HMOD) in Hypertensive Emergencies

Prevalence of Myocardial Injury and Myocardial Infarction in Patients with a Hypertensive Emergency: A Systematic Review

Non-ST Elevation Myocardial Infarction in Patients With Hypertensive Emergency

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